Chapter 100: Basic Principles of Cancer Chemotherapy

Chapter 100: Basic Principles of Cancer Chemotherapy

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse wants to evaluate a nursing student’s understanding of chemotherapy. The nurse asks, “Which of the following would be a major impediment to successful chemotherapy?” Select the student’s best response.

a.	“The patient’s reluctance about the doses administered.”
b.	“The patient’s degree of nausea.”
c.	“The toxicity of anticancer drugs to normal tissues.”
d.	“Difficulty attaining and maintaining venous access.”

 

 

ANS:   C

The major impediment to successful chemotherapy is the toxicity of anticancer drugs to normal tissues.

The patient’s reluctance regarding the dose is vague and not a good choice.

The patient’s degree of nausea should not be an issue, because many good antiemetics may be given prophylactically.

The question does not address whether the chemotherapy is administered PO or IV, therefore this response would be an assumption.

 

DIF:    Cognitive Level: Application             REF:    p. 1167

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. The nurse educator at a hospital is teaching a patient education class about the characteristics of neoplastic cells. To evaluate understanding, the nurse asks, “What is the most distinguishing property of an invasive growth?” Which response by a participant demonstrates a need for further teaching?

a.	“Unrestrained growth and division; malignant cells are unresponsive to feedback mechanisms.”
b.	“Normal tissues remain segregated and don’t invade other tissues.”
c.	”Division of neoplastic cells always occurs rapidly.”
d.	“Malignant cells are free of constraints that inhibit invasive growth and can penetrate adjacent tissues.”

 

 

ANS:   C

The division of neoplastic cells is not necessarily rapid. Although some cancers are composed of cells that divide rapidly, others are composed of cells that divide slowly. This statement indicates a need for further teaching.

Malignant cells are unresponsive to the feedback mechanisms that regulate cellular proliferation in healthy tissue; no further teaching is needed.

In the absence of malignancy, tissues remain segregated from one another; cells of one type do not invade territory that belongs to cells of a different type. No further teaching is needed.

Malignant cells are free of the constraints that inhibit invasive growth; no further teaching is needed.

 

DIF:    Cognitive Level: Application             REF:    p. 1168

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

 

3. A nurse is evaluating a patient who is receiving chemotherapy. The nurse checks the patient’s neutrophil count and notes that it is 900 cells/mm³. What intervention by the nurse would be most appropriate?

a.	Skip the next dose of chemotherapy and notify the prescriber.
b.	Discontinue chemotherapy, because it is at a dangerous level.
c.	Hospitalize the patient, because there is a risk of possible infection.
d.	Continue to monitor the neutrophil count carefully, in case it continues to drop.

 

 

ANS:   D

Neutrophil counts must be monitored. Normal counts range from 2500 to 7000 cells/mm³. If neutropenia is substantial (ie, an absolute neutrophil count below 500/mm³), chemotherapy should be withheld until the neutrophil count returns toward normal.

The next dose should not be skipped unless the neutrophil count is below 500/mm³.

The chemotherapy should not be discontinued, because the low neutrophil level is not considered “substantial” yet.

There is a risk for infection, but hospitalization is not indicated. The patient is safer in the home environment.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1175

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

 

4. The nurse is caring for a newly admitted patient who has been receiving chemotherapy as an outpatient. The nurse notes that the patient’s gums and nose are bleeding. Laboratory test results confirm severe thrombocytopenia. The nurse should expect the prescriber to order

a.	vitamin K.
b.	erythropoietin (Epogen).
c.	a unit of packed red blood cells.
d.	platelet infusion.

 

 

ANS:   D

Platelet infusion is the mainstay of treatment for patients with severe thrombocytopenia. Oprelvekin may also be used, but it is not offered as an option in this question.

Vitamin K is not indicated for thrombocytopenia.

Erythropoietin and packed red blood cells are indicated for anemia, but the scenario does not indicate that the problem is anemia.

 

DIF:    Cognitive Level: Application             REF:    p. 1176

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies